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Onyx embolization for dural arteriovenous fistulas: a multi- institutional study.

Authors :
Yangchun Li
Chen, Stephanie H.
Guniganti, Ridhima
Kansagra, Akash P.
Piccirillo, Jay F.
Ching-Jen Chen
Buell, Thomas
Sheehan, Jason P.
Ding, Dale
Lanzino, Giuseppe
Brinjikji, Waleed
Kim, Louis J.
Levitt, Michael R.
Abecassis, Isaac Josh
Bulters, Diederik O.
Durnford, Andrew
Fox, W. Christopher
Polifka, Adam J.
Gross, Bradley A.
Sur, Samir
Source :
Journal of NeuroInterventional Surgery; Jan2022, Vol. 14 Issue 1, p57-62, 7p
Publication Year :
2022

Abstract

Background Although the liquid embolic agent, Onyx, is often the preferred embolic treatment for cerebral dural arteriovenous fistulas (DAVFs), there have only been a limited number of single-center studies to evaluate its performance. Objective To carry out a multicenter study to determine the predictors of complications, obliteration, and functional outcomes associated with primary Onyx embolization of DAVFs. Methods From the Consortium for Dural Arteriovenous Fistula Outcomes Research (CONDOR) database, we identified patients who were treated for DAVF with Onyx-only embolization as the primary treatment between 2000 and 2013. Obliteration rate after initial embolization was determined based on the final angiographic run. Factors predictive of complete obliteration, complications, and functional independence were evaluated with multivariate logistic regression models. Results A total 146 patients with DAVFs were primarily embolized with Onyx. Mean follow-up was 29 months (range 0-129 months). Complete obliteration was achieved in 80 (55%) patients after initial embolization. Major cerebral complications occurred in six patients (4.1%). At last followup, 84% patients were functionally independent. Presence of flow symptoms, age over 65, presence of an occipital artery feeder, and preprocedural home anticoagulation use were predictive of non-obliteration. The transverse-sigmoid sinus junction location was associated with fewer complications, whereas the tentorial location was predictive of poor functional outcomes. Conclusions In this multicenter study, we report satisfactory performance of Onyx as a primary DAVF embolic agent. The tentorium remains a more challenging location for DAVF embolization, whereas DAVFs located at the transverse- sigmoid sinus junction are associated with fewer complications. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
17598478
Volume :
14
Issue :
1
Database :
Complementary Index
Journal :
Journal of NeuroInterventional Surgery
Publication Type :
Academic Journal
Accession number :
154790498
Full Text :
https://doi.org/10.1136/neurintsurg-2020-017109